NPIMap

Organization Active NPI

Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Indianapolis, IN
National Provider Identifier
1366148991
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
Practice address
2560 N Shadeland Ave
Indianapolis, IN 46219-1705
Phone
(317) 803-1010
Fax
(317) 803-0186
NPI assigned
Feb 6, 2023
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Albert Bowles
Title
Vice President
Phone
(610) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2560 N Shadeland Ave
Indianapolis, IN 46219-1705

Mailing address

1201 S Collegeville Rd
Collegeville, PA 19426-2998
Phone (214) 932-8018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000922 IN Part B Supplier - Independent Clinical Laboratory 3173420585 Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0665318Quest Diagnostics Clinical Laboratories, Inc2560 North Shadeland Ave, Indianapolis, IN 46219AccreditationFeb 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Smithkline Beecham Labo101 organizations share this tax ID, including this one
Part of
Corning Nichols

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2560 N Shadeland Ave
Ste B
Indianapolis, IN 46219

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1366148991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S COLLEGEVILLE RD",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262998",
            "telephone_number": "214-932-8018",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191705",
            "telephone_number": "317-803-1010",
            "fax_number": "317-803-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BOWLES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-454-6000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.